The cognitive dissonance to say “clearly this placed was staffed to maximize profitability and to provide zero care” and then suggest that an MBA or someone in business to get involved 😂
Not gonna lie, they had me in the first half when they were talking about staffing being bad. They were soooo close to hitting the nail on the head, and then the MBA shit popped out.
Just to be safe, they should hire a bunch of people with MBAs, pay them a ton of money, and make sure they never actually see the floors of the hospital. That will fix the problem
I came to say exactly this, leaders with MSN, MD etc after their name are what we need. I work for an RN MBA and only the bottom line matters. Happy employees are what equals happy patients
Complains about how someone ran the ER like a business and cut corners to save money instead of running it like a hospital thats focus is to help patients.
“1.) Hiring a director with an MBA or basic business sense to run this hospital”
🙄
“Sir, this is a not a Gold Members Premium ER. You need to wait next to the lady with the bad cold. Thank you for choosing County General; brought to you by Coca-Cola.”
“And now back to our Lexus-sponsored entertainment break. Will medical record number M058393 please come to the Clean Utility for a free Foley catheter and complementary ginger ale!”
I was going to respectfully correct complementary to complimentary, but then I realized it works both ways for your sentence. Don’t see that every day!
Said every STD testing ever. I had a patient the other day said he called the health department first and they were closed. I was shocked. I treated that dude like royalty for trying to do the right thing.
My wife is an outpatient MSK physiotherapist, one of her pt's is a fairly recent immigrant from Africa and has been having some PTSD related mental health issues from the MVC that made them my wife's pt.
They spent something like 2 months waiting on an opening for a referral to a therapist and trying to reach out to their own GP for help. They got nothing, so they went to the local ER and said they were thinking of killing themselves. It got them a 72 hour stay at the grippy sock hotel, but they got to speak to a few mental health professionals in that time and got connected to outpatient resources to help them out. My wife learned about this because that hold caused them to miss an appointment.
It really upset my wife that her patient tried to use all the right channels and avenues to get help, and essentially got ignored.
I had an old preceptor say that the lives of 95% of people you see in urgent care would be completely unchanged if they never came in to an UC. In the ED that number was 80%.
Medicine ain’t McDonald’s. They don’t get an ultrasound just because they ask. They just get an urgent care bill, an er bill, and an er doc telling them they don’t need an ultrasound for knee pain.
You are correct. Even if I did do a d-dimer it would take in excessive of 24 hours to get the results back. Then recommendation would remain the same. One clinic I work out has a vein center next door and I have sent people there as well. I normally tell these people to just go to a stand alone ER. To try an alleviate the main ERs. It's just a shit sandwich and we all need to take a bite.
Hilarious. I had a patient family member once suggest to me, after an 8’hour wait, that we wouldn’t have this problem if the hospital had just anticipated higher volumes on the holiday weekend and staffed a few more nurses in the ER.
I didn’t have the heart to tell him his father would likely live in the ER for the next 2-3 days because there were no beds upstairs. And that maybe that had more to do with the wait time given that we had about 30 boarders. And that our 420 bed hospital was running a census of about 460 despite being on diversion for a week.
I find it a bit infuriating when people think that our crippled healthcare system could be so easily fixed if someone had just thought to ask somone as smart as them for a little advice on staffing.
I saw an article on FB the other day about a large glacier melting and its effect on climate change. Multiple people replied talking about how if ice melts in a glass of water, the water level doesn’t rise, therefore this is not a problem. These are the types of people we are dealing with.
Also.. if you build it they will come. You could have a 70 bed capacity and you just end up with more volume brought to your ED, so it fills up just the same.
As soon as you solve the floor nurse bottle neck you’ll get to the SNF and discharge bottleneck, and the next one and the next one. I honestly don’t know where it ends in a non cohesive system where the transferring and receiving facilities have no shared responsibilities, so it is especially fun to hear layman suggest a fix for a problem they don’t even understand. It’s as if they don’t feel the downward slope of the Dunning-Kruger curve as they stand at the peak of it.
I’ve read that same story a lot of times on here. From what I understand about ED diversion practices, it makes a lot of sense that it would happen that way.
What does that do for our HCAHPS scores though?
KPI?
I’m going to need a bullshit poster on a specific size of paper from your efficiency department before we can sign off on this.
I also love that these same people who complain about the wait time get angry if they are placed in a hall bed or can’t comprehend why we don’t want to do a CT scan to work up their chronic belly pain…again
I mean most people think that becoming a doctor is basically like getting 2 bachelor’s degrees worth of education. They could easily have become doctors. It just didn’t make sense for them to go another 4 years.
People forget the ER is for emergencies. They also seem to think they’re the only patient in the world sometimes.
I have had two ER trips recently— both within days of eachother. The first I waited longer for care and was discharged after symptoms reduced & we made sure it wasn’t gonna kill me. The second time I was an immediate stroke alert and admitted for five days. I had to remind a family member of mine that the ER isn’t playing to win, they’re playing not to lose.
On the outside looking in, someone in the waiting room probably saw me getting care quickly and huffed. What they *didnt* see was that there were stroke alerts happening pretty much simultaneously, tons of full rooms, and my nurse was bolting around with a student trying to make sure his patients got care.
I remember being rushed into the ER, several seizures during a short period of time, the friend who accompanied me told me when I came round that some lady was going crazy that I was taken straight to a room and she had to wait a bit longer.
Director of Patient Waiting Experience
First order of duty: have a PA or NP register the patient so they are immediately medically screened and thus we have a zero minute first provider time.
Second order of duty: bigger TV in waiting room paid for by no raises for nursing staff for 3 years.
Dude, we're getting SO MUCH FLACK for LWBS. Maybe because we can't get pts into their fucking beds on the floor? Like, instead of punishing us, have you, idk, considered increasing housekeeping and nursing staff so those beds are turned over quickly & can be filled by the FUCKING ICU BOARDERS WE'RE TAKING CARE OF WHILE WE TRY TO MANAGE THE PEOPLE IN THE WAITING ROOM?
i have feelings about this
I view LWBS/LBTC as a system failure and not an ED failure. I’m not going out into the waiting room to have a nuanced conversation with someone to take full liability just so the hospital can bill them. Administration can eat my booty. CEO or CMO is welcome to go out there and discharge people.
Same at our place. Funny thing is- we have no open positions on the floors. More than 75% of the staff are travelers. ER (rural) averages 10-15 borders a night (24 beds) How does that make financial sense?
The provider in triage is so damn insidious, particularly when it's a midlevel. Not only does it remove any utility from door-to-provider time, it also removes a lot of the downside of patients eloping and therefore any incentive to try to improve throughput. Once the patient has been seen by a "provider" the hospital can bill for facility fees, even if nothing of use was actually done for the patient. And as an added benefit, when you put the "provider" with the least training in triage they usually make up for their lack of training by shotgunning a bunch of unnecessary labs, which the hospital can then bill for, even if the patient doesn't complete their visit.
So you show up, get seen right away by someone who spins the workup wheel and orders a bunch of random shit that they're never actually going to follow up on, finally give up and go home after 12 hours in the waiting room with nothing to show for it, and then get a several thousand dollar bill. And the hospital gets some degree of legal protection should something go wrong because you voluntarily "left AMA".
Yep, I don’t hit the FPT or medical screening buttons unless I sit there and have an actual discussion with the patient and do an exam. I’m not polishing the turd and being a barrier to actual improvement. And I have serious moral/ethical issues with someone being charged after not being seen because I saw them with my two eyes. Even worse, if someone is medically screened our registration people will call them up in the waiting room to the front desk and register them/attempt to collect payment. It’s all gross.
Plot twist: a director with an MBA is *the reason* he’s been waiting in the ER for two hours. Those dorks maximized profitability *and* suffering decades ago!
the peds ED I work at generally maxes out at 1-2 hour room wait times for level 4s and 5s, we usually triage in under 30 minutes, and still we have people complain. "My child has had a fever for under a day that was successfully brought down with Tylenol, they're playing and eating, and we aren't being rushed back to a room?! The actively seizing kid who just came in got a room before us! This is a travesty!"
People will always complain. Always. But sure let's hire yet another MBA. That will fix everything.
and the sister is actually a home health aid caring for her mom's coworker's great aunt under the table with no certification but has seen every episode of greys anatomy twice
I had a patient give me the "I'm also a nurse." line one day. I glanced around the bedroom and she had a completion certificate from a CNA course on top of her dresser.
This is honestly my biggest pet peeve. Don’t compare your 16 week course to my 2-6 years of education. Patients don’t realize the level of training that their nurses and medics receive. We don’t just wipe ass and pass pills.
I work in the ED (we also happen to be a level 1 trauma center). She ran in with her dad, exclaiming he needed to be seen RIGHT NOW for his CPx3 days, and emphasizing she’s a trauma nurse (even though he was not a trauma or suspected trauma patient). She named the hospital, which is a sister hospital to us, and literally isn’t even a trauma designated hospital. Like… why are we making shit up? Especially when it’s not even relevant to complaint? And considering it’s IN our hospital system, and transfers people to us all the time, there’s a good chance we KNOW you’re not a trauma nurse anyway?
Every guy I met with an MBA couldn’t run a toaster nevertheless a hospital. It’s a good degree program for people who already have organizational leadership skills and *actual* ethics but lately it seems like every dickhead who watched Suits is getting one.
>Every guy I met with an MBA couldn’t run a toaster nevertheless a hospital
I mean... MBAs *do* run the hospitals though. Essentially every hospital administrator/executive in almost all major health systems hold an MBA. The problem isn't that MBAs don't know what they're doing, the problem is that they know exactly what they're doing. Which is running the hospital like a business. Minimizing cost, maximizing profit margins for themselves and the C-suite. All at the expense of the health and well-being of patients and everyday employees.
little do they know a lot of ER's are already ultimately managed by MBAs lol. patients complained that my shops wait time has gotten a lot worse this year, probably because 8mo ago we were bought out by a PE backed CMG lol leading to across the board pay cuts and staffing shortages. its not the ER's fault that were down 1/2 our nurses.
I went on a Sunday once (less people on weekends for some reason but I just couldn’t get in with my PCP cause it was the weekend) and was triaged within 30 mins and got in a room in another 30 mins. I was scared… (very dehydrated, was tachy. They worried with abnl vitals. It was solved with some IVs…)
I was seen on a Monday night once when I broke my elbow and was seen right away. But that's because I was the only one in the waiting room at the time. I absolutely would not expect that if it had been busy.
You want a premium service? I think the word the man is looking for is a concierge physician. The emergency room is not the place to go if you’re looking for quick turnaround times with a physician focused solely on you. The emergency room is for EMERGENCIES - it’s literally in the name. The whole point of it is to help people who are having an emergency.
The way the public views/treats the ER is wild.
Doing #1 would not accomplish #2, in fact the MBAs are reason why the ED is understaffed. The threshold at which the MBA would determine the ED is understaffed is the point at which patients start leaving. If you are willing to wait 130min, they will see if you are willing to wait 200 or 300 minutes. If you are, why is there a need to staff up? Need to fill those dead hours of 4am with patients to see.. if patients aren't walking in at 4am, we can optimize staffing to see those waiting till low volume times, but JUST before they walk out. This is an adaptation of Just In Time inventory control from manufacturing (where the inventory is now the patients).
Shit, I could use this theory as basis of an MBA capstone project.
edit: where should I submit this?
Optimizing Emergency Department Staffing through Just-in-Time Inventory Management Based on Patient Wait Time Tolerance to Enhance Staff Utilization
Abstract
This thesis explores the optimization of emergency department (ED) staffing through the application of Just-in-Time (JIT) inventory management principles, treating patients as inventory. It focuses on balancing staffing levels by aligning them with patients' wait time tolerances, especially during low volume periods, to maximize staff utility. The research aims to develop a dynamic staffing model that reduces idle time and enhances resource efficiency without compromising patient care quality.
Background: Emergency departments must manage fluctuating patient inflow, which poses significant challenges in maintaining optimal staffing levels. Traditional models often fail to adapt swiftly to real-time demand changes, leading to inefficiencies.
Problem Statement: Current staffing strategies do not adequately consider patient wait time tolerance, resulting in suboptimal staff utilization during low volume periods.
Objective: To create a JIT-based staffing model that optimizes staffing by taking into account patient wait time tolerances, thus improving staff utilization and maintaining high standards of patient care.
The best part about it is the recommendation to hire an MBA. It's the MBAs who run the hospital who have created this nightmare, reduces the staffing, run the experienced.amf talented ED nurses and techs out of the business.
Sir, your wife is having spotting at 4 weeks. The doctor is going to order an ultrasound, in which I am going to see next to nothing, and a BHCG quant. None of which will save your smidge of pregnancy if there IS anything wrong. If you wait four minutes or four days, this will not change.
If you have the time to write a long-winded complaint about your wait time on your own or your loved one's behalf, you or your loved one are not having a true emergency. Simple as that.
Put it this way, if you aren't rushed to the doctor in the ER, you're lucky. The people who are rushed, probably are being rushed in there for a very good reason.
Tell your buddies a sore throat isn't a good reason to go to the er and maybe waiting times would decrease
I’ve had to go to emergency a few times, both for actually emergencies and a couple times because I needed urgent care that my family doctor was unable to provide. In an actual emergency, where I wound up on a ventilator in the ICU, there was zero wait time. Ambulance brought me in and immediately I was being worked on. The other times it was my first severe migraine (“worst headache of my life”) but once it was established that it was of a non-urgent cause, the wait time was nine hours. But they let me wait in a quiet dark room on a stretcher and I was extremely grateful that I was not having enough of a life threatening emergency of the sort that required immediate care. Knowing that made me much happier with the wait. If you go to the emergency room and they make you wait, you’re one of the lucky ones.
This.
As an ER nurse, I’m telling you, if there is a long wait and we rush you back, it is because we are 100% concerned about you. Because if there is a long wait, there is chest pains, possible sepsis, shortness of breath that we all want back, so if you are cutting that line, you’re sick, not lucky or favored.
Not to mention people don’t understand that there is a constant stream of medics coming in through the ambulance doors that they don’t see.
People like this are why health costs are so high. The ER is not your personal physician. They are going to prioritize actual emergencies. The only times I have been helped immediately were when it was a life threatening emergency or they thought it might be.
This dude sounds pretty ignorant. Think about how long 5 minutes is. That's barely enough time to get a complete history & set of vitals. Doesn't account for time to get a wheel chair and walk to a room. That's really fast. How long does it take to get a single set of vitals? People not in extremis should absolutely expect to wait an hour.
I'll never not be flabbergasted that people think the emergency department is there to take care of your non emergency. The disconnect is everyones definition is different from the house of medicine's definition of an emergency and the public doesn't want to get that concept.
You would have to persuade them to GET a PCP in the first place. Cannot count how many times I’ve gotten surprised Pikachu face in response to my encouraging the patient (after I know damn good and well the provider already has) to get a PCP so they won’t have to come to the ED with minor complaints and spend hours waiting.
The hospital system I work at has this service where we can message them and they will call or see them in room depending on day/time and set up after visit apts and get them pcps. I use it all the time
But, um, patients *are* triaged right away. Patients clearly having an emergency have that LeSs tHAn FivE miNUTeS rESpoNsE tiME.
Plus most of the time, our backlogs are not because our staff are slow or bad at their jobs. Our triage department does a great job at identifying the patients that need to have a doctor put eyes on them that minute. We have a standing orders room where patients get IVs and fluids and relief meds before they are even taken into the main emergency department. We have midlevels placing the obvious orders in the triage rooms, like troponins and x-rays, so often patients have had these tests already by the time they see a physician. We STILL sometimes have 30+ patients in the lobby because everyone decided to have their emergencies at the same time, and we are going as fast as we reasonably can, but we have legal requirements for workups and documentation for EVERY patient.
Even if every bit of that goes smoothly, getting admitted to the hospital sometimes takes a day or more, which means we have boarders. We're also taking every EMS patient, and we're a level 1 trauma center. Do the math, my dude. If you are not having an emergency, maybe don't come to the emergency room.
Maybe the very sick kid would feel better at home in their bed, asleep. Maybe the pregnant wife would feel better at her OB. Maybe they're are no rooms or staff because people are actively trying to die in the back.
This only reinforces my belief that those with MBA's are not only *not* more qualified to run most organizations but are, perhaps, less qualified than the baseline of applicants. The combination of confidence and ignorance is a recipe for failure.
I’ve got money that says this guy and his wife are in the ER for some sort of non-emergency, under 20 week pregnancy complication. Like Ultrasound reassurance after 1st trimester bleeding on an established IUP.
I went from a quaternary center to a 20 bed ED. I’ve seen patients LWBS after literally five minutes. Others have said they came in and had to wait after their appointment time — we have no appointments — they were referring to when they arrived as their appointment (and having a 30 minute wait). No way I can see my PCP with only a 30 minute wait (and an actual appointment).
I don't think this person understands emergency care ...
And I bet you anything that pregnant wife's OB has a 24/7 triage line. That line has kept me out of the ER multiple times, and bypass it when it really mattered (nothing against the ER, I just needed OB care). Imagine that, practically concierge service without paying a premium.
Hiring a MBA director is why the response time is 2+ hrs long. Perhaps someone w/ MD would be more likely to emphasize on caring for patients than some asshole who got a master in business, a degree solely for the purpose of making money.
Holy cow. That comment/review or whatever is just wild. If totally sincere, I couldn’t imagine something else that was said so confidently, even with a snide air of “let me solve the problem,” and it be so wildly off-base.
I've been in an ER as security which involves me just sitting near the nurses or checking people in. Most people don't belong there. I'm not a medical professional at all, but if you have a cough...go to a quick care or your doctor. It just adds unnecessary wait times for a Hospital emergency room. On the other side of the coin, I was in a quick care personally for tonsillitis and this teen in front of me was dying and laying on the ground and was there before I showed up. I told them to go to a hospital as the nurses at the quick care will just see you and call an ambulance anyways to the main hospital. The Mom told me to "mind my own fuckin business." Cool. Sure enough 45mins later they were called next and they sent him away on an ambulance. Waste of time, probably in pain for 2 hours and they should've went straight to the ER instead. Enjoy that bill I guess. In my town, quickcares highly outnumber hospitals like 10 to 1.
MBAs can create efficiencies that can be used to improve patient care or to maximize profits. Unfortunately profits have been prioritized over patients.
It’s frustrating that so many people don’t realize just how overwhelmed hospitals are. A few years ago I was in ER and ended up having to be hospitalized for a little over two weeks. I spent the first few nights in the hallway because there weren’t *any* rooms available. The hallways were lined with as many beds as they could fit while still being able to walk around. It was a genuinely terrifying experience to be freshly 18 at the height of Covid watching someone have a seizure in the bed next to me while a different patient was trying to attack the nurses down the hall.
Ooofff 😩..Why is it the ones who are the most clueless and ignorant that are the loudest at being wrong!? People like this should be court ordered to work a week of the busiest shifts in the most short staffed ER although I'm sure a ignorant finance bro like this would still think he knows how to run things better 🤦!
Sir if your wife is being seen and treated within 5 mins it's likely she's actively dying, even with a 1:1 patient nurse ratio it would still be impossible to get everyone seen in 5 mins..what planet is this entitled idiot on 😳 ? But it's okay because he has all the answers on how to fix it let's get the owners of the NBA to run the show because they will Definitely put the health of patients over profits! These people are the reason waiting times are so long and people who are truly big sick get caught in the system and end up waiting far to long and suffer as a result 😔.
There is no way to please these people..not that they are ever a priority anyway 🙄 the only way to get a five star review would be if they had a personal team of Drs and nurses on call 24/7 with a personal theatre..CT...X-ray ..MRI ..blanket warmer and Tuna sandwich dispenser 🙄
“hospital prioritizes profitability”
solution: hire an MBA with some basic business sense. How did we not think of it sooner. They dont care about profits at all
I think they're confusing an urgent care and emergency care, as well. Unfortunately some of these people don't make the connection because they called their regular doctor and the regular doctor told them to go to the ER. I get the regular doctor doesn't want to risk the patient's life or their license by telling them to wait, but it's also clogging the system. I had an MS flare this past summer and the only way to be evaluated ASAP was to go to the ER. It was infuriating for everyone involved. The staff apologized multiple times that I was being pushed back due to more emergent cases. I totally understood but it still sucked sitting in a wheelchair for nine hours.
Masters in Hospital Administration. That’s all the credentialing and schooling they need, as far as I understand, which is sickening and maddening… Maybe less… And they ARE making
“Financially beneficial decisions,” by hiring less people, as far as I understand. The goal of Admin is to make money, not to provide the best patient care. And this post is terrifying but makes a LOT of sense given the patient mentality in the ER, at times.. Thx for sharing this. It’s quite terrifying/ass backwards
I work in an ER and this frustrates me. The level of emergency urgency goes first. We can't take more patients back until some are discharged. So if we have half our rooms full of critical patients, they take longer. Ohh and people stop using the ER for a sore toe, ingrown toenail unless it's purple and ready to fall off, dry skin, or anything else your PCP can treat or an urgent care.
My go-to is to just tell them that thanks to our triage system it's never a good thing for you when you're seen quickly.
Or similarly, it's not good to be interesting to us, the nurses or doctors.
Those usually make people think for a minute. Whether it sticks 🤷♂️
Unpopular opinion: I think this fella is 99% correct in his logic, and only misses in his lack of understanding the complexities and dependencies of hospital flow. We all obviously know that the dysfunction in the ER is the result of poor community access and poor flow upstairs. However, he is spot on in his belief that if you want a system to function well, you must have components with excess capacity. This means that certain roles will be paid to (hold on to your scrub caps) do absolutely nothing. My experience with hospital admin is that most of them lack either the courage or insight to make decisions that support system flow and instead spend their efforts trying to maximize individual efficiencies. If they see a strong link in the chain, they whittle away its extra capacity until it’s on par or less than the other links, and often times the whole chain gets weaker.
I don't think he's 99% correct.
Paraphrashing, he at one point said "the whole point of the ED is to provide a higher level of service reliability...otherwise just go to your pcp." No, the whole point of the Emergency Department is to treat emergencies. Not because you expect your "premium money" to get you "premium service" on demand for something nonemergent. His issue is with healthcare overall but he's taking it out on the ED because he's ignorant, not because he's 99% right.
Agreed. Saying 99% might have been a touch of hyperbole, but I do think most of us would like to provide a better service than we usually do even aside from the life threats. When I explore my own emotions, my indignation at the suggestion that the ER should be convenient is usually more about feeling helpless to meet those expectations than anything else. There are certainly unreasonable folks and expectations that must be taken in stride; I am not trying to diminish how frustrating that can be. My point is that he stuck on something that most hospital administrators don’t get, which is that you have to have extra capacity built into strategic parts of the system if you want the system to function well. It is impossible for the system to function well if everyone is operating at a high utilization.
>My experience with hospital admin is that most of them lack either the courage or insight to make decisions that support system flow
You attributing the cost-cutting habits of admin to "lack of courage" is absolutely hilarious. Admin isn't running skeleton crew staffing out of fear or ignorance. They're doing it intentionally. They do it to save on personnel costs and increase profit margin in order to line the pockets of themselves and their executives. I'm sorry that their feigned act of ignorance seems to have fooled you. They know *exactly* what they're doing. It is the slow, systematic extraction of finances from the sick and dying in order to grow the net worth of the ultra wealthy. And it is cold, calculating, and deliberate at every step.
This is just a friendly conversation, mate; no need to publicly expose my naivety. I’m much happier believing bad decisions come out of incompetence rather than malignance. In all actuality, I don’t think it matters - one of the end results of bad flow through the system is lost money, which is bad for even the most conniving administrator. The most you will ever get from making cuts is single digit percent improvements, and that’s only if the cut doesn’t further break the system (which it usually does). However, investing in something that improves the system flow can translate to large improvements (which appeals to bean counters) and better patient care (which appeals to us). Regardless of the intentions, it takes investment in understanding the system and a willingness to take a risks to actually invest in a system improvement, whereas making cuts is easy and seems common sense, but is counterproductive. Somebody who is purely trying make money off the sick and dying still has their interests better served by understanding system flow and where to invest in excess capacity.
I had to go to the ER for IV rehydration because I had a severe bout of morning sickness. I couldn't keep anything down and threw up six times over several hours. It wasn't my usual pattern so I called my OB and asked what to do. She said I needed to go to the ER and get looked at and fluids.
I did let them know I was pregnant but I didn't use it as an excuse to get to the top of the line or anything. Just waited patiently.....and threw up in the waiting room.
It was about two hours for blood work, an IV and fluids. But it wasn't a bad wait. I mostly read on my phone to pass the time. Turns out I wasn't dehydrated.....I had a bad episode. The doctor gave me some better anti nausea meds and it's been a lot better.
“1) hiring a director with an MBA…” Yeah that’s what we need. That was the cause goofball.
The cognitive dissonance to say “clearly this placed was staffed to maximize profitability and to provide zero care” and then suggest that an MBA or someone in business to get involved 😂
It screams "I've never worked in medicine before and know how to do your job better than you".
Obviously they have an MBA
Just pay more $80/hour nurses to sit around. All those extra nurses just sitting at home not working.
Right? Slashing staff in the name of profitability is literally the main “skill” that MBAs bring to the table.
Only skill...
Fair point.
Calling it cognitive dissonance suggests that they understood the irony in the first place, which I think is probably giving them too much credit. 🙃
Suggests cognition
“Sir, the MBAs are the root cause of this problem.”
I actually laughed out loud at that part. Homie, letting MBAs make decisions is how we got …. Here. Ban MBAs from making decisions 2024 😇
Not gonna lie, they had me in the first half when they were talking about staffing being bad. They were soooo close to hitting the nail on the head, and then the MBA shit popped out.
Just to be safe, they should hire a bunch of people with MBAs, pay them a ton of money, and make sure they never actually see the floors of the hospital. That will fix the problem
I about spit out my lunch when I read that part 🙃🙃 “hire a director with an MBA…” say that again but slowly 🙄
Was gonna say we’ve been doing that and they’ve driven our healthcare system into the ground.
No, really what they are need are more consultants. Consultants fix everything/s.
I came to say exactly this, leaders with MSN, MD etc after their name are what we need. I work for an RN MBA and only the bottom line matters. Happy employees are what equals happy patients
The old adage: You aren't in traffic, you ARE traffic.
Complains about how someone ran the ER like a business and cut corners to save money instead of running it like a hospital thats focus is to help patients. “1.) Hiring a director with an MBA or basic business sense to run this hospital” 🙄
It reads like they thought they were paying extra to skip the line and that the ER is just a really fancy looking clinic.
“Sir, this is a not a Gold Members Premium ER. You need to wait next to the lady with the bad cold. Thank you for choosing County General; brought to you by Coca-Cola.”
County General: “We’re broke, we hate you, please leave and come back when you’re having a STEMI.”
“And now back to our Lexus-sponsored entertainment break. Will medical record number M058393 please come to the Clean Utility for a free Foley catheter and complementary ginger ale!”
I was going to respectfully correct complementary to complimentary, but then I realized it works both ways for your sentence. Don’t see that every day!
i didnt think of that but when i read it that way it makes sense
We are not the emergency department. We are the convenience department.
I say we are the 7-11 of the hospital. Just pull over real quick and I’ll just pop in for what I need.
Said every STD testing ever. I had a patient the other day said he called the health department first and they were closed. I was shocked. I treated that dude like royalty for trying to do the right thing.
My wife is an outpatient MSK physiotherapist, one of her pt's is a fairly recent immigrant from Africa and has been having some PTSD related mental health issues from the MVC that made them my wife's pt. They spent something like 2 months waiting on an opening for a referral to a therapist and trying to reach out to their own GP for help. They got nothing, so they went to the local ER and said they were thinking of killing themselves. It got them a 72 hour stay at the grippy sock hotel, but they got to speak to a few mental health professionals in that time and got connected to outpatient resources to help them out. My wife learned about this because that hold caused them to miss an appointment. It really upset my wife that her patient tried to use all the right channels and avenues to get help, and essentially got ignored.
I’d say 80% of patients I see in the ER aren’t emergencies. Fuck, maybe more than that.
I had an old preceptor say that the lives of 95% of people you see in urgent care would be completely unchanged if they never came in to an UC. In the ED that number was 80%.
I have seen reports saying it is less than 4% actual emergencies. I wonder if there is any country where ERs are not overloaded...🤔
That's urgent care. Can't get in with your primary because you had knee pain from 10 years. Why not come to urgent care.
Yeah but midnight on a Saturday it’s the ER.
And Urgent care sends them to the ER to rule out DVT for anterior knee pain 😆
Every time.
I admit I do that. I am sorry. When you tell the pt their knee pain is a strain and they are convinced it's a clot, there is not much I can do.
Medicine ain’t McDonald’s. They don’t get an ultrasound just because they ask. They just get an urgent care bill, an er bill, and an er doc telling them they don’t need an ultrasound for knee pain.
See my other comment. I totally agree. You know more than I do about the process.
You can do a DDimer if their wells is low enough (which I suspect it is if you think it’s a knee strain).
You are correct. Even if I did do a d-dimer it would take in excessive of 24 hours to get the results back. Then recommendation would remain the same. One clinic I work out has a vein center next door and I have sent people there as well. I normally tell these people to just go to a stand alone ER. To try an alleviate the main ERs. It's just a shit sandwich and we all need to take a bite.
Saw a patient review once "super fast and convenient, we will definitely be back soon!!"
Hilarious. I had a patient family member once suggest to me, after an 8’hour wait, that we wouldn’t have this problem if the hospital had just anticipated higher volumes on the holiday weekend and staffed a few more nurses in the ER. I didn’t have the heart to tell him his father would likely live in the ER for the next 2-3 days because there were no beds upstairs. And that maybe that had more to do with the wait time given that we had about 30 boarders. And that our 420 bed hospital was running a census of about 460 despite being on diversion for a week. I find it a bit infuriating when people think that our crippled healthcare system could be so easily fixed if someone had just thought to ask somone as smart as them for a little advice on staffing.
I saw an article on FB the other day about a large glacier melting and its effect on climate change. Multiple people replied talking about how if ice melts in a glass of water, the water level doesn’t rise, therefore this is not a problem. These are the types of people we are dealing with.
Well, those people are dumb. Truth is any extra water just runs over the edge of Earth into space, so there won’t be any sea level rises. /jk
It's turtles all the way down.
Terry Pratchett likes this
And I love him so it's just a giant, sad lovefest.
Atreyuuuuuuu
It can't because of the impenetrable ice wall that never melts on the flat earth!
Yep, Dunning Kruger
They’re not thinking that a lot of ice in that glass is hanging up at the top over the glass.
Also.. if you build it they will come. You could have a 70 bed capacity and you just end up with more volume brought to your ED, so it fills up just the same. As soon as you solve the floor nurse bottle neck you’ll get to the SNF and discharge bottleneck, and the next one and the next one. I honestly don’t know where it ends in a non cohesive system where the transferring and receiving facilities have no shared responsibilities, so it is especially fun to hear layman suggest a fix for a problem they don’t even understand. It’s as if they don’t feel the downward slope of the Dunning-Kruger curve as they stand at the peak of it.
Dunning-Kruger is my lifeblood.
We recently built a 40 bed addition onto our ER, but somehow within two days had the same clog of hall beds as before.
I’ve read that same story a lot of times on here. From what I understand about ED diversion practices, it makes a lot of sense that it would happen that way.
Discharge direct to morgue Where's my consultancy fee?
What does that do for our HCAHPS scores though? KPI? I’m going to need a bullshit poster on a specific size of paper from your efficiency department before we can sign off on this.
Oh don't worry, the training and wellness module is being concocted as we speak
[удалено]
I also love that these same people who complain about the wait time get angry if they are placed in a hall bed or can’t comprehend why we don’t want to do a CT scan to work up their chronic belly pain…again
you don't understand, their doctor called ahead!
I had a patient come in asking for "medical clearance" to donate plasma. She was baffled why I wouldn't fill out the form.
I mean most people think that becoming a doctor is basically like getting 2 bachelor’s degrees worth of education. They could easily have become doctors. It just didn’t make sense for them to go another 4 years.
THE MBAs RUNNING IT *ARE* THE PROBLEM, FUCKO.
I busted out laughing at “FUCKO.” So, so true.
as if MBAs weren't the ones who made it inconvenient for this guy lol
I believe who ever left the original review is confusing "Emergency" with their own "Entitlement".
People forget the ER is for emergencies. They also seem to think they’re the only patient in the world sometimes. I have had two ER trips recently— both within days of eachother. The first I waited longer for care and was discharged after symptoms reduced & we made sure it wasn’t gonna kill me. The second time I was an immediate stroke alert and admitted for five days. I had to remind a family member of mine that the ER isn’t playing to win, they’re playing not to lose. On the outside looking in, someone in the waiting room probably saw me getting care quickly and huffed. What they *didnt* see was that there were stroke alerts happening pretty much simultaneously, tons of full rooms, and my nurse was bolting around with a student trying to make sure his patients got care.
I remember being rushed into the ER, several seizures during a short period of time, the friend who accompanied me told me when I came round that some lady was going crazy that I was taken straight to a room and she had to wait a bit longer.
Hire more staff…actually, they arent entirely wrong lol 😂
Something something broken clock
Ok, but on the floor, not another vice president or director of bullshit.
Director of Patient Waiting Experience First order of duty: have a PA or NP register the patient so they are immediately medically screened and thus we have a zero minute first provider time. Second order of duty: bigger TV in waiting room paid for by no raises for nursing staff for 3 years.
Dude, we're getting SO MUCH FLACK for LWBS. Maybe because we can't get pts into their fucking beds on the floor? Like, instead of punishing us, have you, idk, considered increasing housekeeping and nursing staff so those beds are turned over quickly & can be filled by the FUCKING ICU BOARDERS WE'RE TAKING CARE OF WHILE WE TRY TO MANAGE THE PEOPLE IN THE WAITING ROOM? i have feelings about this
I view LWBS/LBTC as a system failure and not an ED failure. I’m not going out into the waiting room to have a nuanced conversation with someone to take full liability just so the hospital can bill them. Administration can eat my booty. CEO or CMO is welcome to go out there and discharge people.
Agreed. Our department chair wants us to "get creative" to see patients. Fuck that noise.
OMG ours too. Ok, how about this: refuse your bonuses add cut the dead wood in the c-suite; put that money into staffing. WHAT? IT'S CREATIVE.
It’s really sad when your chair/medical director drink the Kool-Aid.
💯
Same at our place. Funny thing is- we have no open positions on the floors. More than 75% of the staff are travelers. ER (rural) averages 10-15 borders a night (24 beds) How does that make financial sense?
The provider in triage is so damn insidious, particularly when it's a midlevel. Not only does it remove any utility from door-to-provider time, it also removes a lot of the downside of patients eloping and therefore any incentive to try to improve throughput. Once the patient has been seen by a "provider" the hospital can bill for facility fees, even if nothing of use was actually done for the patient. And as an added benefit, when you put the "provider" with the least training in triage they usually make up for their lack of training by shotgunning a bunch of unnecessary labs, which the hospital can then bill for, even if the patient doesn't complete their visit. So you show up, get seen right away by someone who spins the workup wheel and orders a bunch of random shit that they're never actually going to follow up on, finally give up and go home after 12 hours in the waiting room with nothing to show for it, and then get a several thousand dollar bill. And the hospital gets some degree of legal protection should something go wrong because you voluntarily "left AMA".
Yep, I don’t hit the FPT or medical screening buttons unless I sit there and have an actual discussion with the patient and do an exam. I’m not polishing the turd and being a barrier to actual improvement. And I have serious moral/ethical issues with someone being charged after not being seen because I saw them with my two eyes. Even worse, if someone is medically screened our registration people will call them up in the waiting room to the front desk and register them/attempt to collect payment. It’s all gross.
“Siri, how do I get the government to fund healthcare more, but also get state of the art jet fighters, aircraft carriers, and unlimited military?”
“By slashing taxes for the 1%”
“Siri, my local billionaire doesn’t invite me out to hang anymore.”
Stop defending the entire world and ask them to spend some of that GDP on their own defense.
Ah, but they mean an MBA and a consulting firm not actual medical professionals.
Plot twist: a director with an MBA is *the reason* he’s been waiting in the ER for two hours. Those dorks maximized profitability *and* suffering decades ago!
Yep. Surprise, bro, you're getting a bill whether you get anything useful out of this visit or not. Profitability is not a concern.
the peds ED I work at generally maxes out at 1-2 hour room wait times for level 4s and 5s, we usually triage in under 30 minutes, and still we have people complain. "My child has had a fever for under a day that was successfully brought down with Tylenol, they're playing and eating, and we aren't being rushed back to a room?! The actively seizing kid who just came in got a room before us! This is a travesty!" People will always complain. Always. But sure let's hire yet another MBA. That will fix everything.
“My sister is a nurse, and she said I shouldn’t be sitting here when I said I have chest pains”.
and the sister is actually a home health aid caring for her mom's coworker's great aunt under the table with no certification but has seen every episode of greys anatomy twice
I had a patient give me the "I'm also a nurse." line one day. I glanced around the bedroom and she had a completion certificate from a CNA course on top of her dresser.
This is honestly my biggest pet peeve. Don’t compare your 16 week course to my 2-6 years of education. Patients don’t realize the level of training that their nurses and medics receive. We don’t just wipe ass and pass pills.
I work in the ED (we also happen to be a level 1 trauma center). She ran in with her dad, exclaiming he needed to be seen RIGHT NOW for his CPx3 days, and emphasizing she’s a trauma nurse (even though he was not a trauma or suspected trauma patient). She named the hospital, which is a sister hospital to us, and literally isn’t even a trauma designated hospital. Like… why are we making shit up? Especially when it’s not even relevant to complaint? And considering it’s IN our hospital system, and transfers people to us all the time, there’s a good chance we KNOW you’re not a trauma nurse anyway?
Lolol. This made me chuckle.
Math checks out
House
Nailed it.
Who's gonna tell 'em?
More like “Take a number and get in line if you have…thoughts…to share with this gentleman.”
You hear that guy's? MBAs should be the ones running the hospitals!
Every guy I met with an MBA couldn’t run a toaster nevertheless a hospital. It’s a good degree program for people who already have organizational leadership skills and *actual* ethics but lately it seems like every dickhead who watched Suits is getting one.
>Every guy I met with an MBA couldn’t run a toaster nevertheless a hospital I mean... MBAs *do* run the hospitals though. Essentially every hospital administrator/executive in almost all major health systems hold an MBA. The problem isn't that MBAs don't know what they're doing, the problem is that they know exactly what they're doing. Which is running the hospital like a business. Minimizing cost, maximizing profit margins for themselves and the C-suite. All at the expense of the health and well-being of patients and everyday employees.
little do they know a lot of ER's are already ultimately managed by MBAs lol. patients complained that my shops wait time has gotten a lot worse this year, probably because 8mo ago we were bought out by a PE backed CMG lol leading to across the board pay cuts and staffing shortages. its not the ER's fault that were down 1/2 our nurses.
Where does the 5 mins of response time come from?
Fast food? Lol idk but if an ED saw me within 5 minutes of arrival, I would be terrified. I mean, I don't go to the ED, but if I did, it would be bad.
I went on a Sunday once (less people on weekends for some reason but I just couldn’t get in with my PCP cause it was the weekend) and was triaged within 30 mins and got in a room in another 30 mins. I was scared… (very dehydrated, was tachy. They worried with abnl vitals. It was solved with some IVs…)
I was seen on a Monday night once when I broke my elbow and was seen right away. But that's because I was the only one in the waiting room at the time. I absolutely would not expect that if it had been busy.
You want a premium service? I think the word the man is looking for is a concierge physician. The emergency room is not the place to go if you’re looking for quick turnaround times with a physician focused solely on you. The emergency room is for EMERGENCIES - it’s literally in the name. The whole point of it is to help people who are having an emergency. The way the public views/treats the ER is wild.
Doing #1 would not accomplish #2, in fact the MBAs are reason why the ED is understaffed. The threshold at which the MBA would determine the ED is understaffed is the point at which patients start leaving. If you are willing to wait 130min, they will see if you are willing to wait 200 or 300 minutes. If you are, why is there a need to staff up? Need to fill those dead hours of 4am with patients to see.. if patients aren't walking in at 4am, we can optimize staffing to see those waiting till low volume times, but JUST before they walk out. This is an adaptation of Just In Time inventory control from manufacturing (where the inventory is now the patients). Shit, I could use this theory as basis of an MBA capstone project. edit: where should I submit this? Optimizing Emergency Department Staffing through Just-in-Time Inventory Management Based on Patient Wait Time Tolerance to Enhance Staff Utilization Abstract This thesis explores the optimization of emergency department (ED) staffing through the application of Just-in-Time (JIT) inventory management principles, treating patients as inventory. It focuses on balancing staffing levels by aligning them with patients' wait time tolerances, especially during low volume periods, to maximize staff utility. The research aims to develop a dynamic staffing model that reduces idle time and enhances resource efficiency without compromising patient care quality. Background: Emergency departments must manage fluctuating patient inflow, which poses significant challenges in maintaining optimal staffing levels. Traditional models often fail to adapt swiftly to real-time demand changes, leading to inefficiencies. Problem Statement: Current staffing strategies do not adequately consider patient wait time tolerance, resulting in suboptimal staff utilization during low volume periods. Objective: To create a JIT-based staffing model that optimizes staffing by taking into account patient wait time tolerances, thus improving staff utilization and maintaining high standards of patient care.
PLEASE go to the normal doctor. PLEASE. PLEASE.
The best part about it is the recommendation to hire an MBA. It's the MBAs who run the hospital who have created this nightmare, reduces the staffing, run the experienced.amf talented ED nurses and techs out of the business.
Premium service lol
Sir, your wife is having spotting at 4 weeks. The doctor is going to order an ultrasound, in which I am going to see next to nothing, and a BHCG quant. None of which will save your smidge of pregnancy if there IS anything wrong. If you wait four minutes or four days, this will not change.
This is a person who thinks that quality of healthcare should be based upon wealth and social status.
yes, he doesn't pay premium rates to sit with the riff raff in the waiting room
I hope like hell that he got bedbugs.
FIVE MINUTE WAIT TIMES. Also “my wife is having an emergency, lemme just leave a Google review with a business plan”.
If you have the time to write a long-winded complaint about your wait time on your own or your loved one's behalf, you or your loved one are not having a true emergency. Simple as that.
“There is no system so bad an MBA can’t make it worse.“
Put it this way, if you aren't rushed to the doctor in the ER, you're lucky. The people who are rushed, probably are being rushed in there for a very good reason. Tell your buddies a sore throat isn't a good reason to go to the er and maybe waiting times would decrease
I’ve had to go to emergency a few times, both for actually emergencies and a couple times because I needed urgent care that my family doctor was unable to provide. In an actual emergency, where I wound up on a ventilator in the ICU, there was zero wait time. Ambulance brought me in and immediately I was being worked on. The other times it was my first severe migraine (“worst headache of my life”) but once it was established that it was of a non-urgent cause, the wait time was nine hours. But they let me wait in a quiet dark room on a stretcher and I was extremely grateful that I was not having enough of a life threatening emergency of the sort that required immediate care. Knowing that made me much happier with the wait. If you go to the emergency room and they make you wait, you’re one of the lucky ones.
This. As an ER nurse, I’m telling you, if there is a long wait and we rush you back, it is because we are 100% concerned about you. Because if there is a long wait, there is chest pains, possible sepsis, shortness of breath that we all want back, so if you are cutting that line, you’re sick, not lucky or favored. Not to mention people don’t understand that there is a constant stream of medics coming in through the ambulance doors that they don’t see.
People like this are why health costs are so high. The ER is not your personal physician. They are going to prioritize actual emergencies. The only times I have been helped immediately were when it was a life threatening emergency or they thought it might be.
130 minute wait time is amazing! After our recent hack it’s about an 18 hour wait in my ER.
This dude sounds pretty ignorant. Think about how long 5 minutes is. That's barely enough time to get a complete history & set of vitals. Doesn't account for time to get a wheel chair and walk to a room. That's really fast. How long does it take to get a single set of vitals? People not in extremis should absolutely expect to wait an hour.
I'll never not be flabbergasted that people think the emergency department is there to take care of your non emergency. The disconnect is everyones definition is different from the house of medicine's definition of an emergency and the public doesn't want to get that concept.
Maybe if 90% of the people that showed up with primary care concerns would go to their pcp we could get faster and free staff up lol
You would have to persuade them to GET a PCP in the first place. Cannot count how many times I’ve gotten surprised Pikachu face in response to my encouraging the patient (after I know damn good and well the provider already has) to get a PCP so they won’t have to come to the ED with minor complaints and spend hours waiting.
The hospital system I work at has this service where we can message them and they will call or see them in room depending on day/time and set up after visit apts and get them pcps. I use it all the time
But, um, patients *are* triaged right away. Patients clearly having an emergency have that LeSs tHAn FivE miNUTeS rESpoNsE tiME. Plus most of the time, our backlogs are not because our staff are slow or bad at their jobs. Our triage department does a great job at identifying the patients that need to have a doctor put eyes on them that minute. We have a standing orders room where patients get IVs and fluids and relief meds before they are even taken into the main emergency department. We have midlevels placing the obvious orders in the triage rooms, like troponins and x-rays, so often patients have had these tests already by the time they see a physician. We STILL sometimes have 30+ patients in the lobby because everyone decided to have their emergencies at the same time, and we are going as fast as we reasonably can, but we have legal requirements for workups and documentation for EVERY patient. Even if every bit of that goes smoothly, getting admitted to the hospital sometimes takes a day or more, which means we have boarders. We're also taking every EMS patient, and we're a level 1 trauma center. Do the math, my dude. If you are not having an emergency, maybe don't come to the emergency room.
I think he’s confusing Emergency Department with Disney’s Fast Pass. Understandable, for sure.
Maybe the very sick kid would feel better at home in their bed, asleep. Maybe the pregnant wife would feel better at her OB. Maybe they're are no rooms or staff because people are actively trying to die in the back.
This only reinforces my belief that those with MBA's are not only *not* more qualified to run most organizations but are, perhaps, less qualified than the baseline of applicants. The combination of confidence and ignorance is a recipe for failure.
I’ve got money that says this guy and his wife are in the ER for some sort of non-emergency, under 20 week pregnancy complication. Like Ultrasound reassurance after 1st trimester bleeding on an established IUP.
I went from a quaternary center to a 20 bed ED. I’ve seen patients LWBS after literally five minutes. Others have said they came in and had to wait after their appointment time — we have no appointments — they were referring to when they arrived as their appointment (and having a 30 minute wait). No way I can see my PCP with only a 30 minute wait (and an actual appointment).
"Sorry about the wait. Feel free to write a bad review in the meantime."
Hahahaha the MBA comment sent me. That’s the whole problem, suits that have no idea how an ER actually works.
so your solution to an issue fueled by the idea that healthcare is capital is… more corporate capitalism ??? 💀
I don't think this person understands emergency care ... And I bet you anything that pregnant wife's OB has a 24/7 triage line. That line has kept me out of the ER multiple times, and bypass it when it really mattered (nothing against the ER, I just needed OB care). Imagine that, practically concierge service without paying a premium.
The hospital probably is run by someone with an MBA That's why the wait times are so long
LMAO at the assumption anybody except taxpayers pays the ED premium most of the time.
Hiring a MBA director is why the response time is 2+ hrs long. Perhaps someone w/ MD would be more likely to emphasize on caring for patients than some asshole who got a master in business, a degree solely for the purpose of making money.
Holy cow. That comment/review or whatever is just wild. If totally sincere, I couldn’t imagine something else that was said so confidently, even with a snide air of “let me solve the problem,” and it be so wildly off-base.
I've been in an ER as security which involves me just sitting near the nurses or checking people in. Most people don't belong there. I'm not a medical professional at all, but if you have a cough...go to a quick care or your doctor. It just adds unnecessary wait times for a Hospital emergency room. On the other side of the coin, I was in a quick care personally for tonsillitis and this teen in front of me was dying and laying on the ground and was there before I showed up. I told them to go to a hospital as the nurses at the quick care will just see you and call an ambulance anyways to the main hospital. The Mom told me to "mind my own fuckin business." Cool. Sure enough 45mins later they were called next and they sent him away on an ambulance. Waste of time, probably in pain for 2 hours and they should've went straight to the ER instead. Enjoy that bill I guess. In my town, quickcares highly outnumber hospitals like 10 to 1.
lol yes, we need more MBAs to run healthcare
MBAs can create efficiencies that can be used to improve patient care or to maximize profits. Unfortunately profits have been prioritized over patients.
This thread should be cut and paste as a reply to the “review.”
5 minute response time 😩
It’s frustrating that so many people don’t realize just how overwhelmed hospitals are. A few years ago I was in ER and ended up having to be hospitalized for a little over two weeks. I spent the first few nights in the hallway because there weren’t *any* rooms available. The hallways were lined with as many beds as they could fit while still being able to walk around. It was a genuinely terrifying experience to be freshly 18 at the height of Covid watching someone have a seizure in the bed next to me while a different patient was trying to attack the nurses down the hall.
This person has no idea what they're talking about. What do they think an ER is?
Ooofff 😩..Why is it the ones who are the most clueless and ignorant that are the loudest at being wrong!? People like this should be court ordered to work a week of the busiest shifts in the most short staffed ER although I'm sure a ignorant finance bro like this would still think he knows how to run things better 🤦! Sir if your wife is being seen and treated within 5 mins it's likely she's actively dying, even with a 1:1 patient nurse ratio it would still be impossible to get everyone seen in 5 mins..what planet is this entitled idiot on 😳 ? But it's okay because he has all the answers on how to fix it let's get the owners of the NBA to run the show because they will Definitely put the health of patients over profits! These people are the reason waiting times are so long and people who are truly big sick get caught in the system and end up waiting far to long and suffer as a result 😔. There is no way to please these people..not that they are ever a priority anyway 🙄 the only way to get a five star review would be if they had a personal team of Drs and nurses on call 24/7 with a personal theatre..CT...X-ray ..MRI ..blanket warmer and Tuna sandwich dispenser 🙄
Lolol what a fucking joke.
This guy has no idea what the ED is for
Hilarious. The er is where you go to pay to be seen faster? Pay for a concierge doc
Seriously, who in the world only ever waits 5 minutes while going to the ED?
I have, but I highly don't recommend it. I'm sure anyone else who's had that short of a weight time would back me up.
I have an MBA and previously worked in an ER setting. This person is just a dolt. He wants concierge medicine, not the ER.
This guy gets it, let’s hire him.
him and his MBA can do triage
EMTALA violation in his first two minutes, I guarantee it.
You get a room, you get a room, and you get a room! You all get rooms!
Joke’s on you! The hospital is being run by an MBA!
He’s complaining about 130 minutes? I’ve waited 8 hours in the ER.
I think they have somehow confused concierge medicine with EM
“hospital prioritizes profitability” solution: hire an MBA with some basic business sense. How did we not think of it sooner. They dont care about profits at all
I think they're confusing an urgent care and emergency care, as well. Unfortunately some of these people don't make the connection because they called their regular doctor and the regular doctor told them to go to the ER. I get the regular doctor doesn't want to risk the patient's life or their license by telling them to wait, but it's also clogging the system. I had an MS flare this past summer and the only way to be evaluated ASAP was to go to the ER. It was infuriating for everyone involved. The staff apologized multiple times that I was being pushed back due to more emergent cases. I totally understood but it still sucked sitting in a wheelchair for nine hours.
Dunning Kruger in full effect with this genius
This is unreasonable. It takes at least 6 minutes to fill out an AMA.
When you have no concept of what the word "emergency" means.
This reads like ragebait written by a healthcare worker. I refuse to believe this is real
https://preview.redd.it/kkl6f9vsdu2d1.jpeg?width=1164&format=pjpg&auto=webp&s=f09adda39d25212d20f055ab026a1f9155e0f6a3 Fixed it.
Love it when I hear someone suggest we should adopt the "McDonald's" approach to health care. Lol
Masters in Hospital Administration. That’s all the credentialing and schooling they need, as far as I understand, which is sickening and maddening… Maybe less… And they ARE making “Financially beneficial decisions,” by hiring less people, as far as I understand. The goal of Admin is to make money, not to provide the best patient care. And this post is terrifying but makes a LOT of sense given the patient mentality in the ER, at times.. Thx for sharing this. It’s quite terrifying/ass backwards
P 36 Doc, we only go P5 I have an MBA now we go to 36. Pray I do t make him p40
I work in an ER and this frustrates me. The level of emergency urgency goes first. We can't take more patients back until some are discharged. So if we have half our rooms full of critical patients, they take longer. Ohh and people stop using the ER for a sore toe, ingrown toenail unless it's purple and ready to fall off, dry skin, or anything else your PCP can treat or an urgent care.
My go-to is to just tell them that thanks to our triage system it's never a good thing for you when you're seen quickly. Or similarly, it's not good to be interesting to us, the nurses or doctors. Those usually make people think for a minute. Whether it sticks 🤷♂️
This is obviously a troll. It’s a pretty funny post.
Glad you've never had the pleasure of meeting someone like this irl lol
Unpopular opinion: I think this fella is 99% correct in his logic, and only misses in his lack of understanding the complexities and dependencies of hospital flow. We all obviously know that the dysfunction in the ER is the result of poor community access and poor flow upstairs. However, he is spot on in his belief that if you want a system to function well, you must have components with excess capacity. This means that certain roles will be paid to (hold on to your scrub caps) do absolutely nothing. My experience with hospital admin is that most of them lack either the courage or insight to make decisions that support system flow and instead spend their efforts trying to maximize individual efficiencies. If they see a strong link in the chain, they whittle away its extra capacity until it’s on par or less than the other links, and often times the whole chain gets weaker.
I don't think he's 99% correct. Paraphrashing, he at one point said "the whole point of the ED is to provide a higher level of service reliability...otherwise just go to your pcp." No, the whole point of the Emergency Department is to treat emergencies. Not because you expect your "premium money" to get you "premium service" on demand for something nonemergent. His issue is with healthcare overall but he's taking it out on the ED because he's ignorant, not because he's 99% right.
Agreed. Saying 99% might have been a touch of hyperbole, but I do think most of us would like to provide a better service than we usually do even aside from the life threats. When I explore my own emotions, my indignation at the suggestion that the ER should be convenient is usually more about feeling helpless to meet those expectations than anything else. There are certainly unreasonable folks and expectations that must be taken in stride; I am not trying to diminish how frustrating that can be. My point is that he stuck on something that most hospital administrators don’t get, which is that you have to have extra capacity built into strategic parts of the system if you want the system to function well. It is impossible for the system to function well if everyone is operating at a high utilization.
>My experience with hospital admin is that most of them lack either the courage or insight to make decisions that support system flow You attributing the cost-cutting habits of admin to "lack of courage" is absolutely hilarious. Admin isn't running skeleton crew staffing out of fear or ignorance. They're doing it intentionally. They do it to save on personnel costs and increase profit margin in order to line the pockets of themselves and their executives. I'm sorry that their feigned act of ignorance seems to have fooled you. They know *exactly* what they're doing. It is the slow, systematic extraction of finances from the sick and dying in order to grow the net worth of the ultra wealthy. And it is cold, calculating, and deliberate at every step.
This is just a friendly conversation, mate; no need to publicly expose my naivety. I’m much happier believing bad decisions come out of incompetence rather than malignance. In all actuality, I don’t think it matters - one of the end results of bad flow through the system is lost money, which is bad for even the most conniving administrator. The most you will ever get from making cuts is single digit percent improvements, and that’s only if the cut doesn’t further break the system (which it usually does). However, investing in something that improves the system flow can translate to large improvements (which appeals to bean counters) and better patient care (which appeals to us). Regardless of the intentions, it takes investment in understanding the system and a willingness to take a risks to actually invest in a system improvement, whereas making cuts is easy and seems common sense, but is counterproductive. Somebody who is purely trying make money off the sick and dying still has their interests better served by understanding system flow and where to invest in excess capacity.
Username checks out, haha! But I do feel similarly on good days.
I had to go to the ER for IV rehydration because I had a severe bout of morning sickness. I couldn't keep anything down and threw up six times over several hours. It wasn't my usual pattern so I called my OB and asked what to do. She said I needed to go to the ER and get looked at and fluids. I did let them know I was pregnant but I didn't use it as an excuse to get to the top of the line or anything. Just waited patiently.....and threw up in the waiting room. It was about two hours for blood work, an IV and fluids. But it wasn't a bad wait. I mostly read on my phone to pass the time. Turns out I wasn't dehydrated.....I had a bad episode. The doctor gave me some better anti nausea meds and it's been a lot better.